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Pathological changes of the spleen mainly result from its failure in transporting and transforming food and water, upbearing clear substances and internal organs, and keeping the blood flowing within the vessels. Therefore, spleen diseases are mainly manifested by poor appetite, abdominal distension or pain, loose stool*, edema, heavy body, visceroptosis and bleeding.

Deficiency Patterns
虚证类

Fig. 11-4 Commonly observed deficiency patterns of spleen diseases

The main deficiency patterns of spleen disease are listed in Fig. 11-4.

Spleen qi deficiency pattern occurs when deficient spleen qi fails to perform its transportation and transformation function. This pattern is marked by dizziness, fatigue, sallow face, indigestion, abdominal distension, lassitude, anorexia and loose bowels.

Sunken spleen qi pattern arises when spleen qi deficiency becomes worse and fails to perform its upbearing function. This change is marked by epigastric bearing-down sensation, more prominent after meals, or urgency of defecation at short intervals with bearing-down feeling of the anus, or chronic persistent diarrhea, or prolapse of the rectum or uterus, associated with shortness of breath, lassitude, reluctance to speak, dizziness, pale tongue with white coating, and relaxed weak pulse.

Spleen yang deficiency pattern is attributed to insufficient yang qi failing to warm and activate the spleen. This condition is usually manifested by cold limbs, coldness and pain in the abdomen, anorexia, abdominal fullness, chronic diarrhea, lassitude, emaciation and edema.*

The pattern of spleen failing to control the blood arises when weak spleen qi fails to control blood, resulting in various kinds of chronic bleeding such as purpura, and flooding and spotting in women. It can be accompanied by sallow complexion, anorexia, loose bowels, lassitude, lack of strength, shortness of breath, reluctance to speak, pale tongue and weak pulse.

Excess Patterns
实证类

Excess patterns of spleen diseases mainly include the pattern of cold-dampness encumbering the spleen and the pattern of dampness-heat in the spleen.

The pattern of cold-dampness encumbering the spleen* arises when exuberant cold dampness encumbers spleen yang and the spleen fails in transportation and transformation. This is marked by epigastric and abdominal distention, stickiness and tastelessness in the mouth, nausea, loose bowels, heaviness sensation of the head and body, or jaundice with dull yellow discoloration, pale plump tongue with white slimy coating and soggy relaxed pulse.

Both patterns of spleen yang deficiency and cold-dampness encumbering the spleen have torpid intake, abdominal distention or fullness, and loose stool, but the former is mainly a deficiency pattern and the latter is mainly an excess pattern.

The pattern of dampness-heat brewing in the spleen* arises when dampness-heat in the middle energizer inhibits the spleen in its transportation and transformation. This pattern is marked by abdominal distention, nausea, vomiting, anorexia, heaviness sensation in the limbs, or jaundice, reddened tongue with yellow slimy coating and rapid soggy pulse.